North Americans eat 10 to 20 times more salt than they need. And the pay for it with high blood pressure, heart failure, and other problems related to fluid retention.

Don’t we need salt?

Salt contains two minerals, sodium and chloride. Sodium is the important one; every cell contains sodium, as do all body fluids. We couldn’t live without it. But while it is essential for body metabolism, sodium can also cause trouble.

How does salt raise blood pressure?

Excess sodium can stay in body tissues and hold extra water. This causes swelling, which raises the blood pressure, which in turn increases stress on the heart. Every third American adult now has an elevated blood pressure. In those over age 65 the figures rise to 70 percent.

The average salt intake in Japan is even higher than in North America—and so is the prevalence of hypertension. Stroke, a complication of hypertension, is the leading cause of death in Japan.

In other societies, such as those in rural Uganda or the Amazon basin, where salt intake is very low, hypertension is virtually unknown even in advanced age. Dr. Lot Page, a respected researcher, stated categorically, “Without exception, low-blood-pressure societies are low-salt societies. Conversely, mass hypertension follows mass salt consumption.

The taste for salt is not inborn. Salitness is something we've learned, and eating salty foods fuels the craving.

Is this true for everyone?

Not everyone is salt sensitive. Some people can eat all they want without ill effects. Most Americans, however, have some vulnerability to salt and there is no satisfactory test for identifying them.

Salt-sensitive people retain sodium which causes edema (swelling). Many people carry five to seven extra pounds of water weight because of excess salt in their bodies. Decreasing salt intake allows the body to shed the excess water.

Some 30 million Americans with mild essential hypertension could normalize their blood pressures by cutting their salt intake to one teaspoon (five grams) a day.

Beside weight and blood pressure control, such a low-salt diet favorably affects PMS (premenstrual syndrome), certain headaches, and some depressions. And it reduces the water logging in chronic heart failure.

What about water pills?

Water pills successfully lower blood pressure by eliminating salt and extra water. But recent research reveals that some diuretics may actually contribute to heart disease by increasing cholesterol levels 5 to 10 percent. Over time, these drugs may also damage the kidneys, promote gout, and accelerate diabetes. Eliminating extra water by natural means is the safer way to go.

Don’t people who take diuretics for high blood pressure have to take them for life?

That was yesterday’s news. The word today is that up to 80 percent of hypertensives can be eased off water pills in response to a low-salt, low-fat diet combined with weight loss and daily walking.

But I can’t stand saltless food!

Salt preferences are not inborn. Saltiness is a learned habit, and eating salty food fuels the craving. Salt masks natural flavors. Shake the habit by seasoning with herbs and spices. Give yourself three weeks. After that, even so-called normal foods will begin to taste salty. For the diehards, use salt substitutes.

What are some high-sodium foods to avoid?

Watch out for baking soda, baking powder, MSG (monosodium glutamate), salty snacks, and anything pickled. Eat less processed foods, baked goods, meats, dairy products, and certain presweetened cereals. Especially shun canned vegetables unless labeled “no salt added.” One tablespoon of canned peas contains as much sodium as five pounds of fresh peas!

How much salt is safe to eat?

Most people are genuinely amazed at how little sodium (salt) the body actually needs in a day—an average of about a half gram or one tenth of a teaspoon, since some sodium occurs naturally in food.

However this is too drastic a change for most of us. Concentrate on cutting down. Instead of two to four teaspoons (10 to 20 grams), limit yourself to one teaspoon (5 grams) of salt a day. This is a reasonably safe limit for most people.

Here are some ideas to help you decrease the salt in your diet:

• Eat lots of fresh, raw foods, both fruits and vegetables. They need no added salt. They also increase potassium stores, which help lower blood pressure.
• If you need them, look for unsalted snacks.
• Undercook vegetables and eat them a bit crispy. They will require less salt.
• Toast bread and cereals for added flavor.
• Learn to flavor foods with lemon juice, fresh herbs, parsley, tarragon, garlic and onions, instead of with salt.
• Take advantage of the excellent salt-free gourmet cookbooks available on the market today.

The average American consumes 15 pounds of salt a year. Reducing this to four pounds would be a major step towards better health.